Prevention services in adult social care. Robin Miller & Kerry Allen Health Services Management Centre

Transcription

1 Prevention services in adult social care Robin Miller & Kerry Allen Health Services Management Centre

2 Why was the research needed? Generally accepted that there is a need to invest in services that prevent older people from accessing social care services and relying on them long-term Formal research evidence for the different prevention interventions is often limited due to: long timescales; difficulties with attribution; bias towards physical health etc.

3 What did we hope to achieve? To understand what prevention services local authorities invest in To gather practice- based evidence from local authorities of the impact of these services To combine practice-based evidence with that of formal research studies to strengthen current knowledge

4 Phase 1 local practice evidence Survey of DASS s in West Midlands Top 3 local prevention interventions & leads Interview with lead 1 Interview with lead 2 Interview with lead 3 What interventions do they invest in? What evidence/other factors informed this? What evidence is gathered regarding effectiveness?

5 Phase 2 formal review of Top 3 Formal literature reviews of Top 3 interventions in region Synthesise this evidence with local practice evidence What is evidence on cost-effectiveness, user outcomes and sustainability?

6 Development & Delivery Social Care Institute of Excellence Joint Improvement Partnership Core Research team Advisory Group of Third Sector Organisations

7 Progress to date. Survey of DASS s in West Midlands 9 DASS responded Interviews with local leads 24 interviews completed Literature reviews & synthesis of regional top 3 In progress

8 What were prevention services? Top three prevention services were Reablement Telecare Information & Advice Others included dementia cafes, extra-care sheltered housing, equipment services, sensory impairment teams, health promotion services, befriending schemes and falls prevention services

9 What evidence did they gather? Evidence gathered was limited and tended to focus on use of services and people s experience of being supported by the service in question Impact was generally focused on the level of local authority funded social care services used by the person concerned outcomes for the individuals were not available in detail Older people rarely involved in deciding what information should be gathered and how it should be used

10 What are the emerging findings? Nature of evidence that leads to investment What evidence local authorities prioritize and how it is collected Volume and nature of service user and carer involvement

11 What evidence guides prevention investment decisions Strong influence of national level policy and evidence CSED POPPs Dementia strategy Telecare services association Local evidence to validate decisions and develop the detail of interventions Demographics JSNA Demand on current services Piloting

12 What kind of evidence Referral data Number of beneficiaries using intervention over time Financial monitoring and costeffectiveness modelling Whether outcomes met Basic demographic data of service users Tracking individual service activity, joint ventures with health. User surveys/customer satisfaction Individual service use post intervention Response times Authorities tend to collate information around resource usage and general experience of service, rather than detail of individual outcomes.

13 Currently 77% of service users do not go on to have other services. Senior manager (reablement) We demonstrated efficiencies through early discharge, avoidance to hospital, avoidance to step down beds, so there as something around 63,000 in efficiencies. Team manager (Telecare) 95% of people have their outcomes met or partially met. Manager (reablement)

14 Involvement of users and carers Investment decision What evidence is gathered? Which provider? How Implemented? Opportunity to feedback on experience as service user Opportunity to feedback as carer

15 Key messages There is a lot of local evidence, but it is dispersed across local authorities and providers, difficult to obtain. Information most used is performance, not outcome. Local authorities do not use a common framework for collecting evidence. Third sector hold a lot of local evidence on prevention. Older people s view of what constitutes prevention is different to local authority view.

16 For more details contact: Kerry Allen k.allen@bham.ac.uk Robin Miller r.s.miller@bham.ac.uk